title: Body temperature and major neurological improvement in tPA-treated stroke patients.
abstract: BACKGROUND
  Major neurological improvement (MNI) at 24 hours represents a marker of early recanalization in ischaemic stroke. Although low body temperature is considered neuroprotective in cerebral ischaemia, some studies have suggested that higher body temperature may promote clot lysis in the acute phase of ischaemic stroke. We hypothesized that higher body temperature was associated with MNI in severe stroke patients treated with tPA, suggesting a beneficial effect of higher body temperature on clot lysis and recanalization.
  
  
  METHODS
  Patients with ischaemic stroke or transient ischaemic attack (TIA) treated with tPA between February 2006 and August 2012 were prospectively included and retrospectively analysed. Body temperature was measured upon admission. MNI was defined by a ≥8 point improvement in NIHSS score at 24 hours as compared to NIHSS score on admission. No significant improvement (no-MNI) was defined by either an increase in NIHSS score or a decrease of ≤2 points at 24 hours in patients with an admission NIHSS score of ≥8.
  
  
  RESULTS
  Of the 2351 patients admitted with ischaemic stroke or TIA, 347 patients (14.8%) were treated with tPA. A total of 32 patients (9.2%) had MNI and 56 patients (16.1%) had no-MNI. Patients with MNI had higher body temperatures compared with patients with no-MNI (36.7°C vs 36.3°C, P = 0.004). Higher body temperature was independently associated with MNI when adjusted for confounders (OR 5.16, P = 0.003).
  
  
  CONCLUSIONS
  Higher body temperature was independently associated with MNI in severe ischaemic stroke patients treated with tPA. This may suggest a beneficial effect of higher body temperature on clot lysis and recanalization.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: C E
authors.initials: CE
authors.lastname: Kvistad
authors.forename: L
authors.initials: L
authors.lastname: Thomassen
authors.forename: U
authors.initials: U
authors.lastname: Waje-Andreassen
authors.forename: N
authors.initials: N
authors.lastname: Logallo
authors.forename: H
authors.initials: H
authors.lastname: Naess
mesh_terms: D000368:Aged; D001831:Body Temperature / Q000187:drug effects*; D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: acute ischaemic stroke; body temperature; major neurological improvement; recanalization; thrombolysis